title: [Case of a focal segmental glomerulosclerosis collapsing variant associated with a hypertrophic column of Bertin].
abstract: A 59-year-old Japanese man admitted to our hospital complaining of anasarca, body weight gain, and elevation of blood pressure. Serum creatinine(Cre), albumin(Alb), cholesterol(chol), and urinary protein were 1.3 mg/dL, 2.5 g/dL, 527 mg/dL, and 10 g/gCr, respectively. An abdominal echography showed a renal mass, which was diagnosed to be a hypertrophic column of Bertin by enhanced CT. His serum Cre and Alb had worsened to 1.6 mg/dL and 1.7 g/dL, respectively, and a renal biopsy was performed. The results showed a segmental sclerotic lesion associated with hypertrophy and proliferation of podocytes in several glomeruli, hence we diagnosed a focal segmental glomerulosclerosis collapsing variant. After steroid pulse therapy and LDL apheresis, his serum Cre level had decreased to 1.1 mg/dL and the urinary protein level to 2.5 g/gCr. Patients with a focal segmental glomerulosclerosis collapsing variant are poor responders to standard therapies, and have a very poor prognosis. For this case, combined steroid pulse and LDL apheresis therapy was effective.
authors.affiliation: Department of Nephrology, Saiseikai Nakatsu Hospital, Osaka, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ishida
authors.forename: Keiji
authors.initials: K
authors.lastname: Shimazu
authors.forename: Kouji
authors.initials: K
authors.lastname: Takaori
authors.forename: Keita
authors.initials: K
authors.lastname: Mori
authors.forename: Soushi
authors.initials: S
authors.lastname: Yorifuji
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nishiguchi
authors.forename: Eriko
authors.initials: E
authors.lastname: Eguchi
authors.forename: Masao
authors.initials: M
authors.lastname: Koshikawa
authors.forename: Atsuo
authors.initials: A
authors.lastname: Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Kuwahara
mesh_terms: D001781:Blood Component Removal; D003131:Combined Modality Therapy; D005923:Glomerulosclerosis, Focal Segmental / Q000145:classification / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D006984:Hypertrophy; D007668:Kidney / Q000473:pathology*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone; D008775:Methylprednisolone